By: Karen Lok Yi Wong, RSW, BSW
Physiotherapists and social workers have many collaboration opportunities. These opportunities could be different working with various client populations and in various settings. In this article, I would like to share my experience as a social worker collaborating with physiotherapists in three long-term care facilities in Vancouver and how we teamed up to support our residents and their families. Good interdisciplinary team collaboration is important because it optimizes residents and families’ access to resources, facilitates better care planning for residents, improves the team’s communication with residents and families, and, thus, brings a more wholistic care to residents.
Introduction and Access to Resources
Newly admitted residents and their families often have questions on fall prevention, rehabilitation, restoration, and mobility strengthening resources. Physiotherapists and social workers can team up in these situations. Social workers can briefly introduce physiotherapy programs and equipment (e.g., walkers, physiotherapy room) to residents and their families so that not all questions fall on the physiotherapists’ shoulders. A physiotherapist can therefore focus their efforts and expertise on handling more urgent and complex issues (e.g., doing admission assessment, seeing a resident who has just fallen).
In British Columbia, physiotherapy and physiotherapy equipment are not covered by the Medical Service Plan (MSP) in long-term care. For residents and their families who have limited resources, they may not be able to afford physiotherapy and the needed equipment. Therefore, physiotherapists, social workers, and other team members (e.g., nurses) will need to work together with the residents and their families to navigate the systems and provide support as much as possible (e.g., searching for possible financial assistance and donated walkers).
Physiotherapists, social workers, and recreation therapists frequently come together regarding residents’ conditions on mobility, socio-emotions, and activity participation as these three areas are interrelated. Coming together helps our interdisciplinary care planning to better suit the needs of the residents. For example, a newly admitted resident is not engaged during the mobility program with a physiotherapist assistant. However, that same resident is very engaged during a group exercise program with a recreation assistant. The physiotherapist, recreation therapist, and social worker notice and communicate these results with one another. The social worker then talks to the resident and their family and realizes that this is related to the resident’s background in terms of the environment they were growing up. The resident has been in a big family for their entire life and, therefore, feels a sense of comfort and joy surrounded by more people. Since the mobility program is one-on-one, it’s not as comfortable for this specific resident. While the resident enjoys the group exercise program because it’s a chance to engage with other residents. The social worker shares this information with the physiotherapist and recreation therapist. By knowing this information, the physiotherapist and recreation therapist can then design a better care plan which tailors to the needs of this resident, such as having more group programs.
Sometimes, issues related to physiotherapy can involve very complex elements of communication and relationship building with residents and their families. Physiotherapists and social workers can collaborate in these situations as well. For instance, a resident’s mobility condition is declining due to aging, as well as other health and cognitive conditions. The resident’s spouse frequently requests to talk to the physiotherapist on staff and expresses hope that the resident will regain their mobility. This hope, unfortunately, is not realistic in this resident’s case. Instead of focusing on the resident, the social worker tries to understand the situation of the spouse – they are the main family caregiver of the resident. The spouse receives pressure from their children to look after the resident well. Since mobility is a big concern to the family as the resident used to be very active, this image deeply influences the family. The family members have a false hope for the resident’s mobility condition. The physiotherapist and social worker can then work together with the resident and the spouse. The social worker would work with the spouse to reduce the stress that is imposed by the family, supporting in such a way that the spouse can handle the complex family dynamics and develop trust on the team. Gradually, the spouse can develop a more realistic hope on the mobility conditions of the resident. The social worker would communicate closely with the physiotherapist and the physiotherapist would then gently introduce mobility programs which are suitable for the residents’ conditions in a way that the spouse can accept.
Families may have many similar questions regarding their loved ones’ mobility conditions. Social workers can help to set up a family meeting and invite a physiotherapist as the speaker. The physiotherapist can help the families know more about the physiotherapy resources and answer their questions. A benefit of having a meeting which gathers different family members together is that they can exchange their experiences, particularly on different stages of the mobility decline in their loved ones. They can learn from each other and have a better idea what to expect so that they will be better prepared on an emotional level.
Lastly, I would like to give my deep gratitude to all the physiotherapists I have collaborated with during my career as a social worker. I learned so much from their knowledge, skills, and expertise. It was my honor to have the opportunity to collaborate with each and every one of them.
Karen Lok Yi Wong was trained in social policy for BA and MA at the University of York in England and social work for BSW at the University of British Columbia in Canada. She is a registered social worker in British Columbia and has been practising in diverse settings related to older adults, such as home support, community senior services centre, and long-term care. She is also a long-term volunteer of the Alzheimer's Society as a family support group facilitator and workshop educator, as well as an active member at the British Columbia Association of Social Workers Seniors Community of Practice.